Manuella Kaster and colleagues begin their
fascinating paper with the sentence: “Repeated
stress elicits neurochemical and morphological changes that negatively affect
brain functioning. “ They go on to demonstrate that caffeine acts to
prevent some of the negative effects of stress on the brain, and to detail the
neurochemical pathways that are involved. Although their experiments were
conducted on mice, this is important research with interesting implications for
human mental health and wellbeing – as well as being good news for people who
love coffee.

We do indeed know that chronic stress affects
people very badly. In mice, the (rather unpleasant) stressful situations in
this experiment included such things as damp bedding, sharing living space with
others, food and water deprivation, cold baths and cages tilted at 45°. And
these poor mice unsurprisingly showed the behavioural and neurological
consequences of this stress. In humans, stress can also have disastrous
consequences. In my department at the University of Liverpool, my colleagues have
demonstrated that the economic crisis in the years between 2008 and 2010 can be
blamed for as many as 1000 people in the UK taking their own lives. We do, absolutely, need to understand how stress affects us. And we
definitely need to find ways to help people (and mice) affected by stress.

But, while research like this is both
fascinating and positive (except, perhaps, for the mice), I do have a scintilla
of worry. And that worry is brought into focus in Kaster and colleagues’ final
sentence; “Thus we prompt the suggestion
that the up-regulated A2AR might be an effective target to correct
brain disorders that involve a synaptic dysfunction, as now observed for the
maladaptive responses to chronic stress.” I’m not completely sure about
this. While I don't doubt (within the parameters of peer-reviewed science) that
Kaster and colleagues have revealed something fascinating about how the brain
responds to chronic stress, it’s a little less certain that this reflects
either “synaptic dysfunction” or “maladaptive responses”, much less a “brain
disorder”. As I understand Kaster and colleagues’ paper, the mice (and their
brains) were responding normally to an abnormal – stressful – situation. It’s
good to know how the brain works. It would be unfortunate to extrapolate that
understanding to infer that such a response is a sign of abnormality,
especially in humans.

Stressful events make us stressed, emotionally
and physically; they have negative cognitive, emotional, physical and
behavioural consequences. Given that we process information in the brain, using
neurotransmitters, it's obvious that there will be a neurological route or
pathway. It's great to know more about that pathway, and maybe that will even
help us become more resilient or recover faster from stressful life events.

The neurological pathway itself isn't (or at
least isn't necessarily) the ‘cause’ of our response to stress. It's a pathway,
not a cause.

An analogy might help. If a driver swerves and
crashes a car, we don't usually regard the steering wheel as the 'cause' of the
crash. The steering wheel was absolutely necessary (almost certainly the
steering wheel was a necessary part of the causal chain), but it didn't
"cause" the crash. OK, we can imagine a weird scenario where a fault
in the steering wheel (grease on the grip, perhaps) might be to blame. But such
scenarios are vanishingly rare. Essentially, the wheel is a part of a mechanism
whereby the cause (the driver's swerve) translates into the crash.

For both the mice, and for us humans for whom
the findings may be extended, the neurological mechanism isn't the cause.
People are stressed by events. We - because we're biological beings - use our
biological brains to respond to stressful events. But the biology enables our
human response it doesn't entail it or determine it. Here, the mice were
stressed by events (rather nasty events) - damp bedding, shared living spaces,
food and water deprivation, cold baths, cages tilted at 45°, inescapable shock and light/dark cycle inversion (a mouse
equivalent of jet lag). These are the causes of stress. The mechanisms are, I
would argue, something else.

So it's fantastic that this research has been
conducted. It's genuinely important and potentially useful. But it doesn't
necessarily mean that these molecular pathways are the "cause" of
psychological distress. It's probably better to think of them as enabling our
normal human responses, not causing them. This is important. The unfortunate
tendency to label undesirable emotions as ‘symptoms’ of ‘illness’ may well
cause us to treat people with less empathy than we should, to ignore the root causes of distress, and to turn to inappropriate medical treatments. I’m all in favour of
understanding how our brains work. I’m slightly less keen on mistaking
mechanisms for causes.

'The unfortunate tendency to label undesirable emotions as ‘symptoms’ of ‘illness’ may well cause us to treat people with less empathy than we should, to ignore the root causes of distress, and to turn to inappropriate medical treatments.'

Absolutely agree, Peter. And I think it's important to bear in mind that emotional repression is a key part of a Capitalist, inequal society in which the majority of people are expected to slot into worker roles that are at odds with human wellbeing. Emotions let us know whether our needs are being met or not, so an essential part of maintaining inequality is encouraging this emotional disconnect.

Also important I think is to consider history of how psychological pathologizing has been used to maintain certain destructive social norms/structures of power -- e.g., woman who went against the strict rules of acceptable female behaviour being put in mental institutions with 'female hysteria', Autistic people being forced to adapt to neurotypical behaviours, which then causes great stress and meltdown behaviour. The same thing is playing out here, in my opinion: Our world clearly does not work, and demands us to live under incredibly unnatural and stressful conditions. And yet, it is still the norm in the field of mental health to pathologize an individual, as if the problem lies within them and not in the human-created social structures that we all suffer under, to varying degrees.

I feel hopeful that psychology is one discipline that will greatly contribute to a radical reshaping of society, such that we design all social structures around meeting human needs/human wellbeing. In such a society I think we would discover just how much psychological illness is the direct result of living under the oppressive, disconnected, isolating and dignity-violating conditions of our current society. A different world is possible!